Filter
Top Products
103VQT1M21
Please photocopy this form when placing an order.
1. Model #
2. Items Ordered
Accessory # Description Price Each Quantity Total Price
Subtotal
Your State & Local Sales Tax
Shipping & Handling 6.95
Total Enclosed
3.Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA Credit Card #
MasterCard Expiration Date
Discover Customer Signature
Make Check or Money Order Payable to: PANASONIC ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
First Last
Street Address
City State Zip
Night ( )
Day ( )
Phone#:
TO OBTAIN ANY OF OUR ACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC’S ACCESSORY ORDER LINE AT 1-800-332-5368
[6 AM-6 PM M-F, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY
ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
In CANADA, please contact your local Panasonic dealer for more information
on Accessories.
Accessory Order Form (For USA Customers)